First-Line Therapy for Type 2 Diabetes With Sodium–Glucose Cotransporter-2 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonists
Authors: Caroline Hanna, Kenneth Pettersen, Nathaniel Pedley
Journal: Annals of Internal Medicine (2023)

LettersApril 2023First-Line Therapy for Type 2 Diabetes With Sodium–Glucose Cotransporter-2 Inhibitors and Glucagon-Like Peptide-1 Receptor AgonistsCaroline Hanna, MD, Kenneth Pettersen, MD, MPH, Nathaniel Pedley, MD, MBACaroline Hanna, MDDepartment of Medicine, Olive View–UCLA Medical Center, Los Angeles County Department of Health Services, Los Angeles, CaliforniaSearch for more papers by this author, Kenneth Pettersen, MD, MPHDepartment of Medicine, Olive View–UCLA Medical Center, Los Angeles County Department of Health Services, Los Angeles, CaliforniaSearch for more papers by this author, Nathaniel Pedley, MD, MBADepartment of Medicine, Olive View–UCLA Medical Center, Los Angeles County Department of Health Services, Los Angeles, CaliforniaSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L23-0006 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR: Choi and colleagues' article (1) is an excellent analysis of the benefits and pitfalls of SGLT2 inhibitors and GLP1 receptor agonists as first-line therapies for type 2 diabetes. It advocates for lower drug costs by using comprehensive cost analyses and a robust incorporation of external data sources. Furthermore, the inclusion of quality-of-life analyses offers a patient-centered approach to diabetes management.A critique of the article is that weight loss is probably underestimated when evaluating injectable GLP1 receptor agonists; therefore, improved quality of life and reduced costs of care are also underestimated. The authors cite a meta-analysis by ...References1. Choi JG, Winn AN, Skandari MR, et al. First-line therapy for type 2 diabetes with sodium–glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists. A cost-effectiveness study. Ann Intern Med. 2022;175:1392-400. [PMID: 36191315] doi:10.7326/M21-2941 LinkGoogle Scholar2. Alexander JT, Staab EM, Wan W, et al. The longer-term benefits and harms of glucagon-like peptide-1 receptor agonists: a systematic review and meta-analysis. J Gen Intern Med. 2022;37:415-38. [PMID: 34508290] doi:10.1007/s11606-021-07105-9 CrossrefMedlineGoogle Scholar3. Marso SP, Bain SC, Consoli A, et al. SUSTAIN-6 Investigators. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2016;375:1834-44. [PMID: 27633186] CrossrefMedlineGoogle Scholar4. Frías JP, Auerbach P, Bajaj HS, et al. Efficacy and safety of once-weekly semaglutide 2·0 mg versus 1·0 mg in patients with type 2 diabetes (SUSTAIN FORTE): a double-blind, randomised, phase 3B trial. Lancet Diabetes Endocrinol. 2021;9:563-74. [PMID: 34293304] doi:10.1016/S2213-8587(21)00174-1 CrossrefMedlineGoogle Scholar5. Poon JL, Boye KS, Thieu VT, et al. Preferences for attributes of medications among patients with type 2 diabetes: a cross-medication class comparison of injection therapies. Curr Res Diabetes Obesity J. 2018;6:555700. doi:10.19080/CRDOJ.2018.06.555700 CrossrefGoogle Scholar Author, Article, and Disclosure InformationAuthors: Caroline Hanna, MD; Kenneth Pettersen, MD, MPH; Nathaniel Pedley, MD, MBAAffiliations: Department of Medicine, Olive View–UCLA Medical Center, Los Angeles County Department of Health Services, Los Angeles, CaliforniaDisclosures: Authors have reported no disclosures of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L23-0006. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoFirst-Line Therapy for Type 2 Diabetes With Sodium–Glucose Cotransporter-2 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonists Jin G. Choi , Aaron N. Winn , M. Reza Skandari , Melissa I. Franco , Erin M. Staab , Jason Alexander , Wen Wan , Mengqi Zhu , Elbert S. Huang , Louis Philipson , and Neda Laiteerapong Metrics April 2023Volume 176, Issue 4KeywordsAtherosclerotic cardiovascular diseaseDiabetes mellitusHbA1cLife expectancyMarkov modelsMedical risk factorsQuality adjusted life expectancyQuality adjusted life yearsQuality of lifeType 2 diabetes ePublished: 18 April 2023 Issue Published: April 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...